The Colorado Mammography Advocacy Project (CMAP) is a well- established mammography surveillance project that currently captures data on over 50% of all mammograms in the 6-county Denver Metropolitan area in Colorado. Through collaboration with over 30 mammography facilities, the database includes records on nearly 500,000 mammograms in over 350,000 women. The database increases in size by 85,000 mammograms annually. Since 1994, 3662 breast cancers have occurred among women in the database, as revealed by periodic matches with the Colorado Central Cancer Registry. In this renewal period new mammography facilities will join CMAP raising coverage to at least 75% including Kaiser Permanente of Colorado, an HMO that will contribute data on at least 45,000 mammograms annually. Pathology data and other follow-up on abnormal mammograms is planned. With the coming adoption of digital mammography, CMAP has plans to assess the diffusion of this technology and assess its potential impact on screening mammography. Four special projects proposed along with continued development of the CMAP database and participation in the Breast Cancer Screening Consortium. An annual technical quality survey of mammography facilities will continue as our Project 1. This survey is unique in that it is the only continuing survey with detailed documented quality performance of mammography facilities in the United States. Project 2 focuses on high risk women and strategies for informed decision making. Project 3 proposes to systematically examine the explanatory variables associated with ethnic breast cancer differentials. This study will compare Black, Hispanic and White women's experiences through the continuum of breast cancer screening, detection, and care. Project 4 is a commitment to assign preventive medicine residents to the CMAP project as one of their regular rotations in each year of the project. This will provide a continuing source of inquisitive physicians and other students generating opportunities to develop new and useful applications of the CMAP database.